Fri Jun 23 2023

103 articles - From Friday Jun 16 2023 to Friday Jun 23 2023

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Gut

The first international Rome consensus conference on gut microbiota and faecal microbiota transplantation in inflammatory bowel disease.

Statements were evaluated and voted on by al members using an electronic Delphi process, culminating in a plenary consensus conference and generation of proposed guidelines. Results and conclusions Our group has provided specific statements and recommendations, based on best available evidence, with the end goal of providing guidance and general criteria required to promote FMT as a recognised strategy for the treatment of IBD.

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Meta-analysis

meta-analyses and systematic reviews

Aliment Pharmacol Ther

Systematic review and meta-analysis: Association between liver fibrosis and subclinical atherosclerosis in nonalcoholic fatty liver disease.

Any degree of fibrosis is significantly associated with subclinical atherosclerosis, with fibrosis severity amplifying the association.

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Clin Gastroenterol Hepatol

Global Incidence and Prevalence of Eosinophilic Esophagitis, 1976-2022: A Systematic Review and Meta-Analysis.

The incidence and prevalence of EoE have increased substantially and vary widely across the world. Further research is needed to evaluate the incidence and prevalence of EoE in Asia, South America, and Africa.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

A randomised, double-blind, placebo-controlled study of the LAG-3-depleting monoclonal antibody GSK2831781 in patients with active ulcerative colitis.

Despite evidence of target cell depletion in blood, GSK2831781 failed to reduce inflammation in the colonic mucosa suggesting no pharmacological effect. The study was terminated early (NCT03893565).

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Effect of different PD-1 inhibitor combination therapies for unresectable intrahepatic cholangiocarcinoma.

Among patients with uICC, ICI-chemo or ICI-target provided more survival benefits than Chemo while achieving comparable prognoses and fewer adverse events than ICI-target-chemo.

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Epidemiology and risk factors for histopathologic characteristics of non-alcoholic fatty liver disease in South America.

In the largest NAFLD cohort study to date from South America, metabolic syndrome, hypertension and T2DM were independently associated with significant fibrosis, severe steatosis, and inflammation. The prevalence of T2DM was lower than the reported global prevalence.

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Faecal and urine metabolites, but not gut microbiota, may predict response to low FODMAP diet in irritable bowel syndrome.

Baseline faecal and urine metabolites may predict response to the LFD.

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Improved health-related quality of life with semaglutide in people with non-alcoholic steatohepatitis: A randomised trial.

Treatment with semaglutide is associated with improvements in the physical components of HRQoL in patients with biopsy-proven NASH and fibrosis compared with placebo. NCT02970942.

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Real-world effectiveness of vedolizumab compared to anti-TNF agents in biologic-naïve patients with ulcerative colitis: A two-year propensity-score-adjusted analysis from the prospective, observational VEDOIBD -study.

After two years of treatment, vedolizumab resulted in higher remission rates than anti-TNF agents.

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Severe hepatitis B flares with hepatic decompensation after withdrawal of nucleos(t)ide analogues: A population-based cohort study.

Severe flares with hepatic decompensation were observed in 1%-2% of patients with CHB after stopping NUC therapy in daily practice. Risk factors included older age, cirrhosis, portal hypertension and male sex. Our findings argue against NUC cessation as part of routine clinical care.

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Am J Gastroenterol

PREVALENCE AND BURDEN OF ILLNESS OF ROME IV CHRONIC IDIOPATHIC CONSTIPATION, OPIOID-INDUCED CONSTIPATION, AND OPIOID-EXACERBATED CONSTIPATION IN THE UNITED STATES.

In this nationwide US survey, we found that Rome IV CIC is common (6.0%) while Rome IV OIC (1.7%) and OEC (0.4%) are less prevalent. Individuals with OIC and OEC have a higher burden of illness with respect to symptom severity and prescription constipation medication use.

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PREVALENCE AND NATURAL HISTORY OF SEGMENTAL COLITIS ASSOCIATED WITH DIVERTICULOSIS.

Although SCAD generally had a benign outcome, types B and D were associated with more severe symptoms and worse clinical course.

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PROXIMAL GASTRIC PRESSURIZATION FOLLOWING SLEEVE GASTRECTOMY ASSOCIATES WITH GASTROESOPHAGEAL REFLUX.

Impaired EGJ barrier function and proximal gastric pressurization following SG are associated with gastroesophageal reflux, especially during strain maneuvers.

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Small-bowel transit scintigraphy in children with paediatric intestinal pseudo-obstruction.

SBS provides a practically feasible assessment of small intestinal motility. It shows a potential utility to help diagnose and characterise PIPO. SBS appears most discriminative in PIPO patients with myopathic involvement. Studies in a larger paediatric population and across different ages are required.

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Clin Gastroenterol Hepatol

Defining Small Intestinal Bacterial Overgrowth by Culture and High Throughput Sequencing.

Our findings confirm =10 3 CFU/mL is the optimal SIBO threshold, associated with gastrointestinal symptoms, significantly decreased microbial diversity, and network disruption. Microbial hydrogen- and hydrogen sulfide-related pathways were enhanced in SIBO subjects, supporting past studies. Remarkably few specific E. coli and Klebsiella strains/species appear to dominate the microbiome in SIBO, and correlate with abdominal pain, diarrhea, and bloating severities.

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Glucagon-like Peptide-1 Receptor Agonist Use in Patients With Liver Cirrhosis and Type 2 Diabetes.

This population-based cohort study showed that GLP-1 RA users exhibited a significantly lower risk of death, cardiovascular events, decompensated cirrhosis, hepatic encephalopathy, and liver failure in patients with T2D and compensated liver cirrhosis. Additional studies are needed to confirm our results.

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Endoscopy

Endoscopic screening of the upper gastrointestinal tract for second primary tumors in patients with head and neck cancer in a Western country.

In 5% of patients with HNSCC, an SPT was detected with endoscopic screening. Endoscopic screening should be considered in a selection of HNSCC patients to detect early-stage SPTs, based on highest SPT-risk and life expectancy depending on HNSCC and comorbidities.

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Endoscopic submucosal dissection assisted by adaptive traction: results of the first 54 procedures.

ESD using the ATRACT device is safe and effective for the colon and rectum but can also be used to assist with procedures in the upper gastrointestinal tract. It may be particularly useful in difficult locations.

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Initial experience in visualized biliary cannulation during ERCP.

Our research confirms that ERDC is a feasible technology for biliary cannulation under direct vision.

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UNDERWATER CAP-SUCTION PSEUDOPOLYP FORMATION FOR ENDOSCOPIC MUCOSAL RESECTION, A SIMPLE TECHNIQUE FOR TREATING FLAT, APPENDICEAL ORIFICE OR ILEOCECAL VALVE COLORECTAL LESIONS.

Our findings suggest that CAP-UEMR is a safe and effective technique for removing nonpolypoid colorectal lesions, including those arising from the appendiceal orifice or ileocecal valve.

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Gastroenterology

ASSOCIATION OF PROTON PUMP INHIBITOR USE WITH INCIDENT DEMENTIA AND COGNITIVE DECLINE IN OLDER ADULTS: A PROSPECTIVE COHORT STUDY.

In adults = 65 years of age, PPI and H2RA use were not associated with incident dementia, CIND, or decline in cognition over time. These data provide reassurance about the safety of long-term use of PPIs among older adults.

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Early ileocecal resection for Crohn's disease is associated with improved long-term outcomes compared to anti-tumor necrosis factor therapy: a population-based cohort study.

These data suggest that ICR may have a role as first-line therapy in CD management and challenge the current paradigm of reserving surgery for complicated CD refractory or intolerant to medications. Yet, given inherent biases associated with observational data, our findings should be interpreted and applied cautiously in clinical decision-making.

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Prevalence and Associated Factors of Bloating: Results from the Rome Foundation Global Epidemiology Study.

Bloating is common throughout the world. Nearly 18% of the general population experience bloating at least once per week. Reported bloating prevalence is lower in older age groups, is most common in women, and is strongly associated with abdominal pain.

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Gut

Psychological symptoms do not discriminate between reflux phenotypes along the organic-functional refractory GERD spectrum.

Psychological symptoms do not differ between nor predict reflux phenotype membership in refractory reflux patients. Findings suggest that psychological symptoms are relevant across the spectrum of GERD, rather than specific to functional oesophageal disorders.

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Hepatology

Emergence of resistance-associated variants during sofosbuvir treatment in chronically infected hepatitis E patients.

In conclusion, viral population dynamics played a critical role during antiviral treatment. High population diversity during sofosbuvir treatment led to the selection of variants (especially A1343V) with lower sensitivity to the drug, uncovering a novel mechanism of resistance-associated variants during sofosbuvir treatment.

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Guidance on treatment endpoints and study design for clinical trials aiming to achieve cure in chronic hepatitis B and D: Report from the 2022 AASLD-EASL HBV/HDV treatment endpoints conference.

Novel biomarkers (HBcrAg, HBV RNA) remain exploratory while nucleos(t)ide analogues and pegylated interferon still have a role in combination with novel agents. Importantly, patient input is encouraged early on in drug development under the FDA/EMA patient-focused drug development programs.

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J Hepatol

Aagenaes syndrome/lymphedema cholestasis syndrome 1 is caused by a founder variant in the 5'-untranslated region of UNC45A.

The c.-98G>T in the 5'-untranslated region of UNC45A is causing lymphedema and cholestasis (Aagenaes syndrome).

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Clinical and biochemical impact of vitamin B6 deficiency in primary sclerosing cholangitis before and after liver transplantation.

Low vitamin B6 status with associated metabolic dysregulation is a persistent feature of PSC. PLP was a strong prognostic biomarker for LT-free survival both in PSC and recurrent disease. Our findings may suggest that vitamin B6 deficiency modifies the disease and provides a rationale for assessing B6 status and testing supplementation.

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Ductular reaction-associated neutrophils promote biliary epithelium proliferation in chronic liver disease.

Overall, our study reveals the accumulation of DRANs as a hallmark of advanced liver disease and a potential therapeutic target to mitigate ductular reaction and maladaptive wound-healing response. Impact and implications Our results indicate that neutrophils are highly plastic and can have an extended lifespan. Moreover, we identify a new role of neutrophils as triggers of expansion of the biliary epithelium. Overall, the results of this study indicate that ductular reaction-associated neutrophils (DRANs) are new players in maladaptive tissue healing response in chronic liver injury and may be a potential target for therapeutic interventions to reduce ductular reaction expansion and promoting tissue repair in advanced liver disease.

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Evaluation and comparison of risk-based and universal prenatal HCV screening programs in Alberta, Canada.

Universal HCV screening diagnoses significantly higher numbers of pregnant individuals infected with HCV compared to risk-based screening. Universal HCV screening or amending risk-based guidelines to incorporate more proxy variables for risk factors should be considered to improve prenatal HCV screening guidelines in Canada and help achieve HCV elimination in the next decade. Impact and implications Hepatitis C virus (HCV) is a bloodborne pathogen that can cause severe liver disease and be vertically transmitted from a mother to her baby during pregnancy. Pregnant individuals in Alberta are currently only tested for HCV if they disclose to their physician engagement in activities that put them at risk for acquiring the infection (risk-based screening). Using a population-wide universal prenatal HCV screening program, our work shows testing based on patient disclosed risk alone significantly underdiagnoses HCV in pregnant individuals and suggests individuals engaging in sex work or risky sexual behaviours are being overlooked with the current risk-based program. Our outcomes represent the first province-wide study to evaluate and compare prenatal HCV risk-based and universal screening programs in Canada and can be used as evidence-based data for updating prenatal HCV screening policies across the country and in similar jurisdictions.

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GARP on hepatic stellate cells is essential for the development of liver fibrosis.

GARP expressed on HSCs drives the development of liver fibrosis via cell contraction-mediated activation of latent TGF-ß. Considering that systemic blockade of TGF-ß has major side effects, we highlight a therapeutic niche provided by GARP and surface-mediated TGF-ß activation. Thus, our findings suggest an important role of GARP on HSCs as a promising target for the treatment of liver fibrosis. Impact and implications Liver fibrosis represents a substantial and increasing public health burden globally, and specific treatments are not available. Here, we show that the protein GARP expressed on hepatic stellate cells (HSCs) drives the development of liver fibrosis. Our findings suggest GARP as a novel target for future therapies of fibrotic disease.

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Liver disease is a significant risk factor for cardiovascular outcomes - a UK Biobank study.

Liver disease activity, by cT1, was independently associated with higher risk of incident CVD and all-cause mortality, independent of pre-existing metabolic syndrome, liver fibrosis or fat. Impact and implications Chronic liver disease(CLD) is associated with two-fold greater incidence of cardiovascular disease(CVD). Our work shows that early liver disease on cardiac MRI (by cT1) was associated with higher risk of major CVD(14%), CVD hospitalisation(27%) and all-cause mortality(19%). Whether for patients, carers, clinicians, and policymakers, there are implications for early prevention of CLD and CVD.

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The novel SALT-M score predicts 1-year post-transplant mortality in patients with severe acute-on-chronic liver failure.

The ACLF-LT-M score predicts mortality within 1-year after LT in patients with ACLF.The ACLF-LT-LoS score predicted median post-LT stay. Future studies using the ACLF-LT scores could assist in determining transplant benefits. Impact and implications Acute-on-chronic liver failure (ACLF) is a common syndrome, characterized by multi-organ failure in patients with cirrhosis associated with high-short term mortality. Liver transplantation (LT) may be the only life-saving procedure available to these patients but clinically unstability can augment the perceived risk of post-transplant mortality at one year. We provided a parsinominous score with clinically, and readily available parameters to objectively assess 1-year post LT survival and predict median length of stay after LT. Using modern estimation techniques, we developed and externally validated a clinical score model called the Sundaram ACLF-LT-Mortality score in 521 U.S. patients with ACLF with 2 or 3+ organ failure (s) and 120 French patients with grade ACLF-3. The area under the receiver operating characteristics curve was 0.72 in the development cohort and 0.80 in the validation cohort. We also provided an estimation of the median length of stay after LT in these patients. Our models can be incorporated in the discussion of risks/benefits in patients with severe ACLF listed for LT. Nevertheless, the score is far from perfect and other factors, such as patient's preference and center-specific factors, need to be considered whe using these tools.

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J Neurogastroenterol Motil

Randomized Controlled Trial of Anti-reflux Mucosectomy Versus Radiofrequency Energy Delivery for Proton Pump Inhibitor-refractory Gastroesophageal Reflux Disease.

The clinical efficacy of ARMS and radiofrequency for the PPI-refractory GERD is equivalent. ARMS, the efficacy of which could be maintained for at least 2 years, is promising endoscopic management for the treatment of refractory GERD.

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Neurogastroenterol Motil

Effect of aging and obesity on esophageal mucosal integrity as measured by baseline impedance.

According to our study findings age and BMI affect independently lower esophageal MNBI values in patients evaluated for GERD. MNBI significantly aids toward GERD diagnosis though in a real-life setting MNBI values much lower than the one previously proposed should be used.

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Plecanatide for the treatment of chronic idiopathic constipation and irritable bowel syndrome with constipation: Post hoc analyses of placebo-controlled trials in adults with severe constipation.

Plecanatide was effective in the treatment of severe constipation in adults with CIC or IBS-C.

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The clinical application value of salivary pepsin in the diagnosis of gastroesophageal reflux diseases.

Peptest has a relatively low diagnostic value for GERD. Post-symptom Peptset is the best sampling time with the optimal value of 86 ng/mL and may have auxiliary diagnostic value for negative 24 h MII-pH patients. Peptest may assist 24 h MII-pH in monitoring proximal reflux.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: Alcohol-related liver disease is the primary driver of cirrhosis-related hospital admissions in the COVID-19 era-What can be done?

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Editorial: Antibiotics and risk of IBD-Can we close the books?

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Editorial: Functional dyspepsia in pregnancy-Distinct approaches to a special population.

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Editorial: Predicting paediatric ulcerative colitis outcomes-how can we improve?

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Gastroenterology

Beyond Clinical Accuracy: Considerations for the Use of Generative Artificial Intelligence Models in Gastrointestinal Care.

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China's fatty liver crisis: A looming public health emergency.

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Gastrointest Endosc

Computer-aided polyp detection (CADe) in real life: not the "CADe-llac" we were promised.

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Gut

SARS-CoV-2 and the liver: clinical and immunological features in chronic liver disease.

Following SARS-CoV-2 vaccination, rare cases of acute vaccine-induced liver injury and the development of autoimmune-like hepatitis have been reported. However, the concomitant elevation of liver enzymes is reversible under steroid treatment.

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J Hepatol

EASL Innovation Recognition Award Recipient 2023: Prof. Koichi Tanaka.

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EASL International Recognition Award Recipient 2023: Prof. Antonio Bertoletti.

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EASL Recognition Award Recipient 2023: Prof. George Papatheodoridis.

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EASL Recognition Award Recipient 2023: Prof. Julia A. Wendon.

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The future of hepatology - "The best way to predict your future is to create it".

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

An Unusual Case of Colorectal Polyposis.

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How Novel Educational Approaches Can Bridge Competence Gaps in Polypectomy Training.

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Uvular Necrosis: A Rare Complication Following Esophagogastroduodenoscopy.

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Which Patients Should We Select for Adjuvant Treatment After Endoscopic Resection of Squamous Cell Carcinoma?

Pubmed   Journal   ReadQx 

Clin Gastroenterol Hepatol

Steps Towards a Greener Endoscopy Unit.

Pubmed   Journal   ReadQx 

YIELD OF SERIAL TESTING FOR TUBERCULOSIS EXPOSURE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASES: ONE TEST IS NOT ENOUGH.

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Endoscopy

A pediatric case of endoscopic fistula closure using a polyglycolic acid sheet.

Pubmed   Journal   ReadQx   PMC

Application of rubber band and clip traction for removal of a submucosal fecalith mimicking a submucosal tumor of the appendix under colonoscopy.

Pubmed   Journal   ReadQx   PMC

Argon plasma coagulation under direct peroral cholangioscopy for intraductal papillary mucinous neoplasm of the gallbladder.

Pubmed   Journal   ReadQx   PMC

Coloenterostomy performed endoscopically using through-the-scope twin clips in a porcine model.

Pubmed   Journal   ReadQx   PMC

Development of a novel colorectal endoscopic submucosal dissection training model.

Pubmed   Journal   ReadQx   PMC

Effective endoscopic treatment of intrahepatic stones after Roux-en-Y hepaticojejunostomy: a pediatric case.

Pubmed   Journal   ReadQx   PMC

Electrohydraulic lithotripsy for ball valve syndrome due to stent-stone complex after endoscopic ultrasound-guided hepaticogastrostomy.

Pubmed   Journal   ReadQx   PMC

Endoscopic debulking of a large colonic lipoma causing recurrent intussusception using endoscopic mucosotomy technique.

Pubmed   Journal   ReadQx   PMC

Endoscopic omental packing in combination with the clip-and-snare method using pre-looping technique for gastric perforation.

Pubmed   Journal   ReadQx   PMC

Endoscopic resection combined with gel immersion and curved laryngoscope for superficial hypopharyngeal cancer.

Pubmed   Journal   ReadQx   PMC

Endoscopic resection for an esophageal inclusion cyst.

Pubmed   Journal   ReadQx   PMC

Endoscopic resection of a granular cell tumor (Abrikossoff's tumor) in the esophagus using cap-assisted band ligation.

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Endoscopic ultrasound-guided biliary recanalization with a novel rendezvous inflated balloon-assisted technique for isolated bile leakage.

Pubmed   Journal   ReadQx   PMC

Endoscopic ultrasound-guided modification of surgical anatomy (from Roux-en-Y gastrectomy to Billroth II-like anatomy) for endoscopic treatment of malignant biliary stenosis.

Pubmed   Journal   ReadQx   PMC

Management of rare biliary duct variants using a nasobiliary drainage tube and wire-guided navigation during laparoscopic cholecystectomy: a case report.

Pubmed   Journal   ReadQx   PMC

Multitraction with a single rubber band and clips: a simple tip for endoscopic submucosal dissection of a recurrent lesion with previous clip.

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Successful removal of a migrated biliary plastic stent using a novel spiral dilator.

Pubmed   Journal   ReadQx   PMC

Tackling tack removal after use of the through-the-scope helix tack and suture device for stent fixation.

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Unexpected gastric perforation during endoscopic submucosal tunnel dissection for early circumferential esophageal cancer.

Pubmed   Journal   ReadQx   PMC

Visualization of a gallbladder neuroendocrine carcinoma using a novel peroral cholangioscope.

Pubmed   Journal   ReadQx   PMC

Gastroenterology

A 16-year-old onset case of pan-colitis with rectovaginal and rectovesical fistulas.

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A mysterious hepatic mass.

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Bariatric surgery for the treatment of NASH - an old solution to a newer problem?

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Health Disparities in Inflammatory Bowel Disease Care Driven by Rural Versus Urban Residence: Challenges and Potential Solutions.

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Measuring the invisible: circulating tumour DNA as a predictive and prognostic marker of response to adjuvant chemotherapy in resected colorectal cancer.

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Small colon polyp with unusual thickening of the surrounding mucosa in a young patient.

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Gastrointest Endosc

Top tips on duodenal lesion assessment in patients with familial adenomatous polyposis and sporadic adenomas (with videos).

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Gut

Monocyte phenotypic liquid biopsy for NASH and liver fibrosis diagnosis: a new kid on the block.

Pubmed   Journal   ReadQx 

Single-cell profiling of gastric cardia adenocarcinoma reveals drivers of cancer stemness and therapeutic targets.

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Unique tumour microenvironment: when ferroptosis activation boosts ICI of liver cancer.

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Hepatology

Letter to Editor: More questions than answers: Response to the POP-NEXT project.

Pubmed   Journal   ReadQx 

Reply: more questions than answers: response to the POP-NEXT project.

Pubmed   Journal   ReadQx 

J Hepatol

A tribute to Professor Peter Ferenci (1948-2023).

Pubmed   Journal   ReadQx 

Acute cholestatic hepatitis in a patient with metastatic melanoma.

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From the Editor's Desk...

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: Antibiotics and risk of IBD-Can we close the books? Authors' reply.

Pubmed   Journal   ReadQx 

Editorial: Functional dyspepsia in pregnancy-Distinct approaches to a special population. Authors' reply.

Pubmed   Journal   ReadQx 

Letter: Experience of switching vedolizumab treatment from intravenous to subcutaneous formulation in Hungary.

Pubmed   Journal   ReadQx 

Gastroenterology

Enhancing Colorectal Cancer Screening Specificity by Integrating Fecal miRNA Signature with FIT and FOBT.

Pubmed   Journal   ReadQx 

Gastrointest Endosc

Endoscopic treatment of achalasia: Dim past, brighter future?

Pubmed   Journal   ReadQx 

Motorized spiral enteroscopy compared with double-balloon enteroscopy.

Pubmed   Journal   ReadQx 

Peroral endoscopic myotomy for opioid-induced esophageal dysfunction: proceed with caution.

Pubmed   Journal   ReadQx 

The clinical outcomes of endoscopic submucosal dissection for superficial circumferential esophageal squamous cell carcinoma may be not as ideal as expected.

Pubmed   Journal   ReadQx 

Gut

Impact of acute alcohol consumption on circulating microbiome in asymptomatic alcohol-related liver disease.

Pubmed   Journal   ReadQx 

Short versus long endoscopic myotomy: how short is too short and how long is too long?

Pubmed   Journal   ReadQx 

J Hepatol

Defining characteristics and outcomes for patients with non-alcoholic fatty liver disease admitted to hospital with decompensated cirrhosis.

Pubmed   Journal   ReadQx 

Neurogastroenterol Motil

Gastroesophageal reflux disease: A complex illness in need of diversified treatment.

Pubmed   Journal   ReadQx